Provisional WHO / UNAIDS Secretariat Recommendations on the Use of Cotrimoxazole Prophylaxis in Adults and Children Living with HIV/AIDS in Africa (UNAIDS, 2000, 4 p.)

(introduction...)

RECOMMENDATION

OPERATIONAL ISSUES

DRUG REGIMENS

RECRUITMENT

FOLLOW UP

DRUG SUPPLY

TRAINING AND EDUCATION

MONITORING AND EVALUATION

FURTHER RESEARCH

OPERATIONAL ISSUES

Selection criteria

Cotrimoxazole prophylaxis should be offered to the following
HIV-positive adults (defined as over the age of 13 years):

· all
persons with symptomatic HIV disease (Stage 2, 3 or 4 of the provisional WHO
classification of HIV infection and disease).

· asymptomatic individuals who
have a CD4 count of 500 or less or total lymphocyte count equivalent

· pregnant women after the first
trimester

Cotrimoxazole prophylaxis should be offered to all HIV-exposed
infants from six weeks of age, using the following criteria:

· any
child born to an HIV-infected woman irrespective of whether the woman received
antiretroviral therapy in pregnancy.

· any child who is identified as
being HIV infected within the first year of life by PCR, HIV serology or by a
clinical diagnosis of HIV infection (according to WHO/national guidelines).

· children older than 15 months
who have had a PCP event, have symptomatic HIV disease, an AIDS defining
illness, or have CD4 percentage less than 15.

Where PCR or other special diagnostic tests are available, this
can be used to confirm the diagnosis in children.

The use of CD4 counts or total lymphocyte counts is not
recommended for consideration of the initiation of therapy in infants because
these measurements are not predictive of the risk of acquiring PCP in infants
less than one year of
age.